Cyclosporin in atopic dermatitis: time to relapse and effect of intermittent therapy

Abstract

The efficacy of cyclosporin (CyA) in the induction of remission in atopic dermatitis has been documented in controlled studies. However, little information is available on the duration of remission after CyA treatment. We studied the length of remission in 43 patients with severe atopic dermatitis after a 6-week treatment period with CyA at 5 mg/kg per day. After a follow-up of 6-26 weeks, depending on the time-point of relapse, a second treatment period with CyA, identical to the first, was performed. Disease activity was evaluated bi-weekly, using six different parameters: 1, a total body disease activity score; 2, the extent of the disease; 3, the occurrence of itch; 4, the occurrence of sleep disturbance; 5, the use of topical emollients; and 6, the use of topical hydrocortisone. A significant decrease in disease activity was observed. The total body disease activity score decreased from the baseline score of 31 to 11.6 at the end of the first part and to 13.4 at the end of the second part of the study. An almost maximal response to treatment was already apparent after 2 weeks of treatment. All the other efficacy parameters studied also showed a significant response to CyA treatment. A similar response to CyA was seen when the patients were re-treated. After both treatment periods, approximately half of the patients relapsed after 2 weeks (42% first part; 54% second part). After 6 weeks follow-up, the relapse rates were 71 and 90%, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

A Short-Term Trial of Tacrolimus Ointment for Atopic Dermatitis

“…Only short-term therapy is advisable with oral cyclosporine because of nephrotoxicity, and most patients have a relapse within six weeks after the withdrawal of the drug. 21 We conclude that tacrolimus ointment is effective in the treatment of atopic dermatitis and that the only drug-related adverse event appears to be the sensation of burning at the site of application. In the special circumstances of our study, in which tacrolimus ointment was applied to a restricted area of skin and the period of treatment was limited to three weeks, the treatment had an acceptable safety profile.…”

Atopic dermatitis: from the genes to skin lesions

“…Numerous articles and books by nonmedical professionals, various self-help groups for all kinds of allergic diseases, and even dedicated news groups on the Internet are stressing this phenomenon. The direct cost to treat these disorders, as in the charges of medical professionals and the cost of medication, as well as the indirect socioeconomic cost, e.g., as a result of lost working days, has been calculated to be several hundred million dollars every year in the US and the UK (2,3), and the annual cost to society was put at 7 billion Deutschmarks in Germany (4). Despite intensive research and signi®cant progress in the ®eld of immunodermatology, a unifying pathogenetic concept of AD has still not been established.…”

Double-culture Method Enhances the in Vitro Inhibition of Atopy-inducing Factors by Lactococcus lactis

“…After culturing, the positive control group (PI-cyclosporin A(CsA)) was treated with 10 µg/ml CsA, and the experimental group (PI-LAB) was treated with 10 µg/ml lactic acid bacteria homogenate. Cyclosporin A is a strong immunosuppressive agent against the T-cell immunity by inhibiting the secretion of IL-1 and IL-2 and by suppressing the proliferation of T helper cell [11,38]. After 1 hr incubation they were stimulated with 50 ng/ml of PMA and 0.5 µM of ionomycin, and washed with cool PBS 6 hr later.…”